[An unconventional use of the laryngeal mask for the therapy of a postoperative atelectasis-induced respiratory insufficiency].

A 90-year-old cardiopulmonary high-risk patient had to undergo a laparatomy due to a perforated ulcus ventriculi. Postoperatively he developed pulmonary insufficiency due to an atelectasis of the upper right pulmonary region. The clinical situation deteriorated because of dyspnoea and exhaustion. Conservative therapy failed. Atelectasis was overcome by a laryngeal mask airway (LMA) inserted without relaxation and anaesthesia. The LMA enabled CPAP-training for 45 minutes added by inflation of the lung up to a peak airway pressure of 22 cm H2O. Problems and risks of this unconventional use are discussed. Reintubation involving the necessity of relaxation and anaesthesia could be avoided by this unconventional use of a LMA. This case report confirms the good tolerance and easy handling of the LMA. It demonstrates a further application of the LMA, which is not only a new device but a new idea of airway management.